Introduction: Central precocious puberty (CPP) is caused by the early activation of hypothalamic-pituitary-gonadal axis (HPG axis), before the age of 8 for girls and 9 for boys. Gonadotropin-releasing hormone agonists (GnRHa) can delay puberty in CPP patients, and this treatment has been a gold stan...
Introduction: Central precocious puberty (CPP) is caused by the early activation of hypothalamic-pituitary-gonadal axis (HPG axis), before the age of 8 for girls and 9 for boys. Gonadotropin-releasing hormone agonists (GnRHa) can delay puberty in CPP patients, and this treatment has been a gold standard for last 30 years. However, it is still controversial over the adverse reactions that may occur during and after the treatment. For the evaluation of the effects of GnRHa on bone mineral density (BMD) and body mass index (BMI), we measured serial BMD and BMI before and after GnRHa treatment in CPP patients.
Methods: In this retrospective study, 31 idiopathic CPP (iCPP) girls were enrolled and anthropometric data including BMI, and BMD including total body (TB) and total body less head (TBLH) were measured. Chronological age (CA), bone age (BA), height, body weight, mid parental height (MPH), predicted adult height (PAH) data were also collected serially at the start of GnRHa treatment, the end of the treatment, and near final height after menarche. All the data were compared after converting to standard deviation score (sds).
Results: GnRHa treatment was started at 8.5±0.7 years (BA 10.3±0.5), and stopped at 10.4±0.5 years (BA 11.7±0.4). Duration of treatment was 1.9±0.7 years, and the age of menarche was 11.6±0.7 years. BMI (CA, BA) increased continuously during treatment and at last follow-up (FU) period (P<0.001), while BMIsds (CA, BA) significantly increased during treatment and decreased after cessation of treatment (P=0.001 by CA, P<0.001 by BA). Ultimately, BMIsds at last FU were not significantly different from that at the start of treatment.
Both the BMDTB and BMDTBLH were increased at last FU visit (P<0.001). According to CA, BMDTBsds was significantly increased and BMDTBLH was significantly decreased (P<0.05). According to BA, BMDTBsds was not different. however, BMDTBLHsds was increased significantly (P<0.05).
Conclusion: In CPP girls, BMI and BMD should be evaluated by sds according to BA that is biologic maturation index. Although there has been a debate about the effect of GnRHa before, we found that GnRHa treatment had no adverse effects on BMI and BMD.
Introduction: Central precocious puberty (CPP) is caused by the early activation of hypothalamic-pituitary-gonadal axis (HPG axis), before the age of 8 for girls and 9 for boys. Gonadotropin-releasing hormone agonists (GnRHa) can delay puberty in CPP patients, and this treatment has been a gold standard for last 30 years. However, it is still controversial over the adverse reactions that may occur during and after the treatment. For the evaluation of the effects of GnRHa on bone mineral density (BMD) and body mass index (BMI), we measured serial BMD and BMI before and after GnRHa treatment in CPP patients.
Methods: In this retrospective study, 31 idiopathic CPP (iCPP) girls were enrolled and anthropometric data including BMI, and BMD including total body (TB) and total body less head (TBLH) were measured. Chronological age (CA), bone age (BA), height, body weight, mid parental height (MPH), predicted adult height (PAH) data were also collected serially at the start of GnRHa treatment, the end of the treatment, and near final height after menarche. All the data were compared after converting to standard deviation score (sds).
Results: GnRHa treatment was started at 8.5±0.7 years (BA 10.3±0.5), and stopped at 10.4±0.5 years (BA 11.7±0.4). Duration of treatment was 1.9±0.7 years, and the age of menarche was 11.6±0.7 years. BMI (CA, BA) increased continuously during treatment and at last follow-up (FU) period (P<0.001), while BMIsds (CA, BA) significantly increased during treatment and decreased after cessation of treatment (P=0.001 by CA, P<0.001 by BA). Ultimately, BMIsds at last FU were not significantly different from that at the start of treatment.
Both the BMDTB and BMDTBLH were increased at last FU visit (P<0.001). According to CA, BMDTBsds was significantly increased and BMDTBLH was significantly decreased (P<0.05). According to BA, BMDTBsds was not different. however, BMDTBLHsds was increased significantly (P<0.05).
Conclusion: In CPP girls, BMI and BMD should be evaluated by sds according to BA that is biologic maturation index. Although there has been a debate about the effect of GnRHa before, we found that GnRHa treatment had no adverse effects on BMI and BMD.
주제어
#Central precocious puberty, Gonadotropin-releasing hormone agonists, Bone mineral density, Body mass index
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